| NPI | 1518961531 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 37807) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NM MD2023-0126) |
| Enumeration Date | 2005-06-08 |
| Last Update Date | 2023-04-13 |